Certified Coding Technician

Location

Allentown, PA | United States

Job description

Full-time, 40 hours per week, day shift, 7:00AM - 4:30PM, Monday-Friday, Remote Position

SUMMARY:

Under general supervision, the certified coder coordinates the processing of fees for professional and technical services provided to clients for the purpose of reimbursement. Reviews and reconciles medical reports and assigns appropriate ICD-10 and/or CPT codes to patient records for accurate reimbursement. Ensures that medical billing conforms to legal and procedural requirements.

PURPOSE:

The purpose of this document is to describe the general nature and level of work performed by personnel as classified; it is not intended to serve as an inclusive list of all responsibilities associated with this position.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following.

1. Researches, analyzes and interprets test orders to identify and determine whether necessary information is present for billing. Identifies any issues or trends and brings them to the attention of management.
2. Reviews all applicable documentation to determine the appropriate ICD 10 and/or CPT codes to assign for the services provided in compliance with requirements of third-party insurance payors and in accordance with Official Coding Guidelines and regulatory requirements related to coding and reimbursement. Certified Coding Technicians must maintain a 97% accuracy rate while meeting productivity standards.
3. Educates and provides feedback to providers and other clinical staff to resolve documentation requirements of third-party payors to support coding compliance.
4. Utilizes coding resources along with any other applicable reference material available to ensure accuracy in coding.
5. Provides assistance with all related activities, coding guidelines, local and national medical necessity guidelines, ICD 10 codes, CPT codes, modifiers and denials as appropriate. Reviews and resolves coding edits and denials that impact claim submission.
6. Follows all HIPAA regulations and upholds a high standard around privacy requirements.
7. Remains up to date with knowledge of ICD 10 and CPT coding conventions and coding guidelines. Maintains technical currency through continuing education and training opportunities. Expected to maintain designated CEUs.

Required Skills

QUALIFICATIONS:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education/Experience:

Minimum 2 years’ experience in ICD 10 and CPT coding in an acute care or insurance setting. Requires knowledge of medical terminology, medical procedures, abbreviations, terms and anatomy, ICD 10 and CPT coding classification systems and regulatory agency requirements.

Pathology Inpatient and Outpatient coding experience required

Language Ability:

Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization.

Math Ability:

Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume. Ability to apply concepts of basic algebra and geometry. Requires strong analytical and investigative skills in order to assign appropriate codes and maintain data integrity.

Reasoning Ability:

Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.

Computer Skills:

Basic computer skills (windows, medical record software, MS Office, etc.) with proficient data entry skills of 40-50 wpm, in addition to basic knowledge of standard office equipment.

Certificates and Licenses:

Active coding certification through AAPC is mandatory for this position (i.e. Certified Professional Coder, CPC) or Certified Outpatient Coder, COC) .

Required Experience

Qualifications:

QUALIFICATIONS:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education/Experience:

Minimum 2 years’ experience in ICD 10 and CPT coding in an acute care or insurance setting. Requires knowledge of medical terminology, medical procedures, abbreviations, terms and anatomy, ICD 10 and CPT coding classification systems and regulatory agency requirements.

Pathology Inpatient and Outpatient coding experience required

Language Ability:

Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization.

Math Ability:

Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume. Ability to apply concepts of basic algebra and geometry. Requires strong analytical and investigative skills in order to assign appropriate codes and maintain data integrity.

Reasoning Ability:

Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.

Computer Skills:

Basic computer skills (windows, medical record software, MS Office, etc.) with proficient data entry skills of 40-50 wpm, in addition to basic knowledge of standard office equipment.

Certificates and Licenses:

Active coding certification through AAPC is mandatory for this position (i.e. Certified Professional Coder, CPC) or Certified Outpatient Coder, COC) .

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